MEDICARE: CAMILA'S HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	AL11408	FL

General Provider Information

NPI Number	:	1184876203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMILA'S HOME CARE LLC

Provider Business Mailing Address
First Line	:	224 SW 67TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2930
Country	:	US
Telephone Number	:	305-401-7930
Fax Number	:	786-953-4302

Provider Business Practice Location Address
First Line	:	224 SW 67TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2930
Country	:	US
Telephone Number	:	305-401-7930
Fax Number	:	786-953-4302

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA D NUNEZ
Credential	:
Telephone Number	:	305-401-7930

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	11/07/2008

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